Walser, R. D., & Chartier, M. (2010). Laying out in anxiety: Acceptance and commitment therapy for values-based living. In G. W. Burns (Ed.), Happiness, healing, enhancement: Your casebook collection for applying positive psychology in therapy (pp. 176-189). Hoboken, NJ: John Wiley & Sons, Inc.
Susan presented to therapy with extreme anxiety and depression. Her key problems involved her work as a nurse for the past 20 years. What if she got the paperwork wrong? What if she delivered the wrong medication to the wrong client? What if she should lose her job? She felt "zoned out", "forgetful", and "unable to think." Her key desire was to manage her anxiety so that it did not interfere with her work and ability to make friends. A 48-year-old white female, Susan was single and lived alone. Her early family life was filled with turmoil; her parents were volatile, and her mother an alcoholic. They fought regularly, often physically. From time to time, Susan would either get involved in the fights or would hide in a neighbor's garage until it was over - times of desperate loneliness. When her parents divorced, her mother's drinking increased and has continued to this day. Not surprisingly, Susan felt fearful and anxious, had few friends, and did not go on dates. During her college years, she went on her first date - and event that was to tragically shape the rest of her life. She was date raped, became pregnant, and had a complicated abortion. It was at this time that she made a decision not to trust men and, when coming to see me some 30 years later, had still not been on another date. Like her mother, she had a history of intense alcohol abuse but had been sober for the last 17 years. Susan's main goals for therapy were to be able to manage her anxiety and work-life better and perhaps one day have a meaningful relationship. The two main therapeutic goals for Susan, from an acceptance and commitment therapy (ACT) perspective, were: 1. Help Susan see how maladaptive avoidance of internal experience was associated with many problems in life functioning, and then move toward acceptance of internal experience. 2. Bring Susan into contact with her personal values and encourage her to take specific actions in relation to those values as a means to bring vitality back to her life. Dr. Walser was the therapist for the case. Maggie Chartier edited and worked on parts of the chapter that did not directly involve the client.